Premium Medicare Hospital Insurance (Premium-Part A) should be considered whenever an aged individual filing for benefits under Title II or for SSI is ineligible for premium-free Part A. Individuals with low incomes who are ineligible for premium-free Part A may qualify for state payment of Part A premiums under the “qualified Medicare Beneficiary (QMB)” program (refer to HI 00801.139).

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  If an individual with a low-income wants to enroll in Premium-Part A on the condition that the state pays the premium, follow the policies and procedures on Part A premium enrollment in HI 00801.140.

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  If an individual wants to enroll in Premium Part A, accept the enrollment regardless of whether the state pays the premium under QMB or whether the individual qualifies for QMB. Follow the policies and procedures in HI 00801.131 through HI 00801.135 and HI 00801.138.

To determine whether an enrollment request should be submitted, cover the following points when interviewing an individual who is not insured for premium-free Part A:

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  The individual’s work history since last filed an application with SSA (be sure to explore if the individual may qualify for a reduced Part A premium on the basis of 30 or more Quarters of Coverage (QCs), including as a spouse, surviving spouse, divorced spouse or surviving divorced spouse as discussed in HI 00801.134); and

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  A general description of the Premium-Part A provision and the premium cost (including the SMI premium cost); and

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  The requirement that states pay Medicare premiums, and cost-sharing amounts for QMBs (refer to HI 00801.139 and HI 00801.140 for a discussion of the QMB provisions).

HI 00801.131 Eligibility for Premium HI

HI 00801.133 Enrollment and Coverage Period

HI 00801.134 Premium Reduction for Aged Individuals With At Least 30 Quarters of Coverage

HI 00801.135 HI Premium Reduction to Zero for Certain Public Retirees

HI 00801.138 Application for Premium HI

HI 00801.139 QMB Provisions

HI 00801.140 Premium-Part A Enrollments for Qualified Medicare Beneficiaries (QMBs) – Part A Buy-In States and Group Payer States